Doppler sonography has been introduced to evaluate uterine and ovarian diseases. It has been reported to be used to distinguish benign from malignant adnexal masses. The purpose of this study was to assess the blood flow characteristics of adnexal masses and to determine the optimal cut-off points for the Doppler indices obtained, resistance index and pulsatility index, to best differentiate benign from malignant lesions. We performed pulsed Doppler ultrasound in seventy-eight adnexal masses between February 1989 and June 1994. The pulsatility and resistance index were calculated from the waveforms generated from blood flow within the ovary. There were 51 benign and 27 malignant histologically proved ovarian lesions. All women have been operated on. The results were as follows ; Benign tumors and cysts had a significantly higher pulsatility index(mean, 1.23+/-0.74; range, 4.46-3.36) and resistance index(mean, 0.64+/-0.19; range 0.34-1.43) than did malignant tumors(pulsatility index : mean, 0.87+/-0.49; range, 0.31-2.27; resistance index : mean, 0.50+/-17; range, 0.23-0.8). However, some overlap in individual values for benign and malignant lesions was found. In conclusion, our data suggest that high pulsatility and resistance indices may indicate benign adnexal masses ; however, considerable overlap in pulsatility and resistance indices between benign and malignant lesions were noted, and further work will be needed before the validity of these factors is proved.
Female ; Humans ; Ovarian Diseases ; Ovary ; Ultrasonography

BACKGROUND: To measure hemodynamic changes during a laparoscopic cholecystectomy (LC), we used a new, noninvasive esophageal doppler monitor (EDM). METHODS: Under general anesthesia, 17 patients undergoing a LC were prepared by inserting an EDM probe into the esophagus. Cardiac index (CI), corrected flow time (FTc), systemic vascular resistance (SVR), mean arterial pressure (MAP), and heart rate (HR) were measured 6 times-before pneumoperitoneum, 5 minutes after pneumoperitoneum, 5, 15, and 30 minutes after the reverse trendelenberg position and after exsufflation of CO2 gas. Complication and insertion time of the EDM were also recorded. Data was analyzed using a repeated measure ANOVA. RESULTS: CO2 gas insufflation resulted in an abrupt increase of SVR (51%), MAP (17%) and a decrease of CI (29%), FTc (13%). These changes were gradually restored, except the MAP. HR was not changed significantly. These findings correlated well with other studies using a thermodilution technique or transesophageal echocardiography. There was no complication with the EDM and insertion time was 182 32.3 sec. CONCLUSIONS: Since MAP and HR do not offer accurate hemodynamic information during pneumoperitoneum, other adequate cardiovascular monitors are required. An EDM can be used during LC because it provides CI and FTc by a simple and noninvasive method.
Anesthesia, General ; Arterial Pressure ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Echocardiography, Transesophageal ; Esophagus ; Heart Rate ; Hemodynamics* ; Humans ; Insufflation ; Laparoscopy ; Pneumoperitoneum ; Thermodilution ; Vascular Resistance

Ovarian mucinous cystadenoma of borderline malignancy was consisted of intestinal mucinous cystadenomas of borderline malignancy and Mullerian mucinous papillary borderline tumors. Mullerian mucinous papillary tumors was lined by mucinous epithelium of endocervical type and characterized by papillae architecturally similar to those of serous borderline tumors. These tumors have clinical and pathologic differences from those of intestinal mucinous cystadenomas of borderline malignancy.We report a case of ovarian Mullerian mucinous papillary cystadenomas of borderline malignancy with review of literature.
Cystadenoma, Mucinous ; Cystadenoma, Papillary* ; Epithelium ; Female ; Mucins* ; Ovary

Clomiphene citrate is the simplest and least expensive from of ovulation induction therapy. In most cases, women who fail to ovulate in response to maximal doses of clomiphene became candidates for treatment with gonadotropins or pulsatile GnRH. Recently, as an alternative to the use of gonadotropins and ovarian surgery, there are some studies of the effectiveness of extended duration clomiphene among the anovulatory women who were resistant to a standard 5-day course of treatment with clomiphene. We have experienced a case of successive ovulation induction and pregnancy with an extended 10-day course of clomiphene in women with clomiphene-resistant anovulatory disorders and reproted with brief reviews of related literatures.
Anovulation ; Clomiphene* ; Female ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Ovulation Induction* ; Ovulation* ; Pregnancy